| NPI | 1477767614 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDY LEE LARSON Owner 503-246-3283 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: OR 2525) |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2020-08-22 |